https://www.theperfectvoice.in/post/strategies-for-prevention-of-violence-in-healthcare

Reports of Physical as well as verbal violence against healthcare institutes is

regularly reported from some State or the other in India. On a few occasions, it

becomes so violent that the crowd may indulge in arson of the hospital and

destroy the costly equipment as well. Though the exact figures are not readily

available, such skirmishes may be nearly thousand or so in a year. According to an

expert, an ongoing study of the Indian Medical Association (IMA) revealed that

over 75% of doctors have faced violence at the work place. Ghastly rape and

murder of resident doctor in State-run R.G. Kar hospital in Kolkata is the most

gruesome of these. Few years ago, in Sassoon Hospital at Pune, one local

Member of the Corporation allegedly assaulted the resident doctor when she

noticed that the latter did not attend a patient on priority. As a reaction, the

resident doctors association threatened to proceed on strike unless the person

who assaulted, was arrested and case was registered under the provisions of

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Prevention of Violence against doctors Act. Similar incidents keep on being

reported regularly from public hospitals as well as private clinics. In few incidents

the violence has even taken the toll of the doctor or usually results in huge

property damage. During the Corona pandemic situation, several incidents of

assault was reported against the health care workers in various parts of the

country. Following these, Union Health Minister had promised that Central Act to

prevent such violence would be promulgated soon, which would have stringent

provisions to prevent recurrence of such incidents. The same has however has not

seen the light of the day.

Violence against doctors is not restricted only to India. Recently in US,

Dr. Michael Davidson, forty-four year old Director of endovascular cardiac surgery

at Brigham and Women’s Hospital and father of three young children (Aged 9, 7

and 2) was killed in cold blood by gunman Stephen Pasceri. Dr. Davidson had

treated Pasceri’s seventy-nine-year-old mother and apparently there had been

some complication and she had died. Pasceri, blaming her physician walked into

the hospital, sought Dr. Davidson out and shot him in cold blood in the very clinic

where he used to treat patients. His friends and colleagues rushed him to the

operating room, but unfortunately he succumbed to his injuries. Similarly,

violence against nurses in US is also commonplace. According to a study,

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nearly million attacks against healthcare institutes are reported in China per year.

Many of these are so violent that the crowd has lynched the doctors as well as

nurses.

In order to prevent such violence, almost twenty-nine states in India

including Maharashtra, Andhra Pradesh, Kerala, Punjab, and Delhi have enacted

legal provisions in the last few years. As per this Act, violence means activities

causing any harm, injury or endangering the life or intimidation, obstruction or

hindrance to any healthcare service person in discharge of duty in the healthcare

service institution or damage or loss to property in healthcare service institution.

The healthcare service persons includes registered medical practitioners working

in healthcare institutions (including those having provisional registration),

registered nurses, medical students, nursing students, para-medical workers

employed and working in medical service institutions. The Act provides stringent

punishment including imprisonment and fine as well as double the amount of

damage as compensation to the institute. These stringent legal provisions do not

permit bail to the accused. The Act also provides forum for the patients to lodge

criminal complaint against the doctors if the patients feel aggrieved. Available

details do not indicate that the Act has deterred the attackers so far. Hardly any

person appears to have been convicted under these provisions. According to Dr

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Neeraj Nagpal, Medico Legal Action group, “only a central Act on lines similar to

state Act will not give the desired results unless changes are also made in Indian

Penal Code.” In his opinion, the issue of arrest of doctors under section 304 A of

IPC is a part of the problem of violence against doctors because invariably cross

FIRs are registered by patient party as well as doctor which results in inevitable

compromise.

In public general hospitals, violence is usually targeted against the

young resident doctors, who are on the starting point of their medical career.

Analysis of these incidents indicates; a) violent incidents happen at places where

there is emergency situation, b) senior doctors were not available and as such

these emergencies were left to be attended by young and inexperienced resident

doctors, c) resident doctors failed to appreciate gravity of the medical emergency

and as such valuable time in saving the patient was lost, d) medical equipment

either are not available or if available not functioning since long and no efforts

were made to keep these in functional and up to date position. In few incidents

resident doctors were reported to be under influence of alcohol and allegedly

misbehaved with the relatives. In view of these violent incidents taking place

repeatedly, and consequently resulting in strikes by resident doctors, I was given

the task of devising a scheme for about twenty five medical colleges-cum5

hospitals run by The State Government of Maharashtra and Mumbai Corporation.

With the help of Medical Superintendents of these hospitals, we identified places

where the trouble starts. It was noticed, at places where, emergency patients are

treated, and when in few occasions, the patient dies, the trouble starts. Hence,

provision was made to deploy small armed contingent from Maharashtra Security

Force (MSF), equipped with proper training, dedicated communication equipment

so that they can call for additional assistance at short notice. These places were

brought under CCTV cameras, and access control was monitored and restricted to

patient and not more than two relatives. These MSF personnel were used for

surveillance, running control room activities and as a quick response team. If

necessary, they would seek help from local police at short notice. As a result of

these measures, which were reviewed from time to time, the situation improved

and the resident doctors expressed their satisfaction, saying that they were able

to focus on treatment better. This system is working effectively in all Medical

Colleges in Maharashtra. In addition, following measures were also initiated:

Tele-medicine facility for prisoners & hospitals

Medical professionals and health workers in public hospitals and

medical colleges remained under constant threat from dangerous prisoners who

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are frequently referred to these hospitals. These prisoners threaten the medicos

to permit their long stay in hospitals under some pretext or the other. They

sometimes stab them or abuse them profusely, causing them great mental and

physical stress.

While working as Advisor in Medical Education Department in 2016-

17, I implemented following scheme. MHA has provided video link in prisons for

connecting with district courts. Ministry of Health has provided video link in

medical colleges and district hospitals for tele-medicine facility. There is a

provision of a doctor in every prison. I asked this doctor to list out the grievances

of prisoners who desired to be referred to specialist doctors. These details were

communicated to specialists by email in advance. After going through the same,

on a scheduled day and time the prisoner was provided video counselling by the

specialist and the prison doctor was given the list of medicines and advice which

was implemented in prison. A weekly time table was announced in advance to

facilitate all concerned.

This system worked very effectively from 2017 till 2020 in all prisons

in Maharashtra. More than three thousand prisoners took advantage of the same

and expressed their complete satisfaction. There is a need to implement the same

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in all hospitals and prisons and save the doctors from the threats of prisoners. The

scheme was implemented without any additional cost to the government.

Another major cause of trouble in public hospitals is the demand

from relatives not to conduct post-mortem of dead person. The same can be

avoided through digital/virtual post -mortem facility which is implemented by

AIIMS, New Delhi. Many advanced countries also implement this facility. This

ensures there are no complaints of fraud or interference in findings. Moreover,

findings can be used at any time with accuracy even though, the body might have

been disposed of.

Private hospitals

In private hospitals, the healthcare workers feel the problem gets

aggravated as invariably, the relatives and friends of the patient who might have

died, approach locally elected politicians, who in turn demands action against the

healthcare workers.

Relatives and friends allege that the healthcare workers including

doctors and nurses show total neglect towards attending the patient in

emergency. They accuse doctors of fleecing the patients by forcing them to

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undergo several tests, which may or may not be relevant. On certain occasions,

according to the relatives, the hospital authorities do not permit removal of the

dead body until the charges are paid in totality. To counter the situation, many

doctors demand that they should be provided with license to possess a weapon.

Analysis of the problem and gravity of the situation indicates that

the issue of violence against healthcare institutes is not simple to be tackled

simply by possessing arms or legal enactment. It calls for determined efforts by

everyone including hospital authorities and healthcare workers. Absence of these

measures results in severe damage including gutting of the costly infrastructure,

injuries to healthcare workers, depression among healthcare workers and severe

impact on reputation of the hospital.

The reasons for violence in healthcare institutes may be sporadic as

well as due to absence of adequate training, lack of infrastructure as well as

absence of any policy to tackle such incidents and inadequate policy to prevent

these. The emphasis should be to take all measures to ensure that such violent

incidents should not take place at all. The foremost thing in this regard is to

arrange for initial as well as mid-term training by experts on regular basis. The

training modules should be addressing each level separately right from the billing

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clerk, receptionist, nurses, ward boys, technicians to resident doctors or senior

most subject experts. The modules should address specific requirements and be

provided by persons two ranks higher in the same hierarchy and not by someone

who is not related to the field. The focus should be on Dos and Don’ts and tips

which can be practically implemented. It is advisable to have case studies and

participants are encouraged to discuss these in the presence of experts to reach

proper conclusions. Fortunately now experts in the field have prepared ‘case

studies bank’ and it can be easily accessed from www.http://ciilm.com/casestudies/.

Training modules can be made more effective if these are delivered

through audio visuals, having actual videos on the subject.

Secondly it is imperative that all those who run healthcare institutes

need to consider all aspects about security right from the time of establishing the

institute and upgrade it from time to time as newer technology becomes

available. Domain experts in security need to be consulted as things which might

appear to be simple may not have been noticed by others. A few things which

may be mentioned include separate entry and exit gates, separate gates for the

technicians and staff as well as for the doctors. Access control is an important

aspect to avoid stampede as well as to prevent intruders. Installation of CCTV

cameras with recording facility for a week and night vision facility is critical. Along

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with the same, there should be adequate trained staff to monitor these and they

need to be equipped with instant communication facility to inform law enforcing

authorities about the developing situation and directions to prevent further

catastrophe. Adequate facility and restricting the number of visitors and persons

accompanying the patients is critical to provide tension free atmosphere for the

doctors, staff as well as for the recovery of the patients.

Documentation of every aberration as well as various incidents is an

important requirement which is generally neglected. If there is a record of the

past incidents, one can see the pattern likely to emerge and prevent or cure

distorted behavior in time. These recordings need to be shown to the staff from

time to time to make them aware what went wrong and how it was possible to

avoid the same. Moreover there is a tendency not to report the incidents to law

enforcing agencies to avoid approaching the police or to remain present in court

to narrate the course of events before the magistrate. Very few are aware that

evidence can be given through video conferencing even if the witness or

complainant is away at a distant place. In fact the single most important reason

for non-conviction in criminal cases involving violence against healthcare

institutes is apathy of the complainants and refusal to appear before the

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magistrates when called to deposit. The complainant can even demand protection

for him as well as witnesses by requesting the court.

According to Dr. Sancheti, leading orthopedist at Pune, mistrust

between patients and doctors is the root cause of violence against the health care

workers. In his long fifty years of practice, he never faced any violent incident, as

he always used to explain each and every step being taken to patients and his

relatives. According to Dr. Sanjay Gupte, the journey to recovery should be a cojourney

of the patient and doctor. Dr. Shrikant Kelkar, Ophthalmic has done

pioneering work in developing training modules for health workers and

implements the same in several hospitals. Dr, Mohan Agashe, psychiatrist states,

‘when there is lack of understanding; it gives rise to legal enactments. Intelligence

and money alone does not solve the problem. Healthcare workers must have

intelligence as well as empathy for the patients.’ He has played a leading role in a

drama prepared at his instance on this very subject.

US Department of Labor, Organizational Safety and Healthcare

facilities’ Roadmap for healthcare facilities has published Guidelines for

Prevention of Violence in Healthcare and is available at www.osha.gov/SLTC/

workplaceviolence. Briefly, these include: i) management commitment, ii)

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employee participation, iii) worksite analysis and hazard identification, iv) hazard

prevention and control, v) safety and health training and vi) record keeping and

program evaluation.

Realizing the gravity of the issue, training modules should be

designed for healthcare workers including doctors, nurses as well as law enforcing

agencies such as police, judicial officers and prosecutors highlighting case studies

of such violence. The Indian Medical Association (IMA) and their local Chapters

should come up with standard operating procedures for establishing any

healthcare facility in public as well as private field. Constant review and rehearsals

should be made at least once in six months to find out aberrations and take

corrective actions. International best practices should be made available as case

studies for continuous guidance.

At present, IMA has suggested formation of ‘crisis management

committee at each Taluka or District level. The committee shall include doctors,

social workers, legal personalities, politicians, press reporters etc. The committee

members may meet the police officers and request them for complete

investigation of the incident and to avoid prosecution of the healthcare worker

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including doctor till the guilt is proved. The committee can also request the press

reporters not to give unnecessary publicity to such cases.’

The Supreme Court in “Martin D’Souza vs Mohammed Isfaq” case

has issued stern warning to police officers against any harassment including arrest

against doctors unless parameter laid down in Jacob Mathew’s case are followed.

Recently, Ministry of Transport, Government of India, has introduced directives to

health workers not to harass the Good Samaritans who come forward to inform

about the injuries to anybody and made it mandatory that the patient be treated

on priority and his life be saved. Police are also directed not to suspect the

persons who inform of such incidents and provide priority to save the life of the

injured.

Strict adherence of these directives and guidelines by all

concerned as well as introspection by healthcare workers and improvement of

their practices and monitoring of these periodically alone can create visible

impact against such violence.

To tackle such incidents of violence, comprehensively, Core India

Institute of Legal Medicine (CIILM) in association with retired police officers in

Maharashtra has launched a unique program in the form of quick response

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teams. These well trained retired police officers who have necessary skill in crowd

controlling, mob psychology and excellent rapport with local police stations have

formed several such quick response teams and working as trainers to health

workers as well as defusing critical situations through their timely interventions.

It would be imperative that every private hospital should join in these efforts in

promoting their welfare and acquiring peace of mind.

To conclude, I would say having enactment to prevent violence, per

se, does not guarantee absence of violence. Involvement from all stake holders,

preparedness to meet the contingencies, well laid out policy with standard

operating procedures (SOP), frequent rehearsals of the drill, coordination with all

stake holders including law enforcement agencies even when there is no crisis are

some of the tips which may help healthcare institutes to avoid and overcome

incidents of violence if any. If the Doctors adopt more sympathetic attitude

towards the patients, and explain the circumstances properly, many adverse

situations can be avoided.

***************##############*********** ######## **********

Author is IPS & Director General of Police (Retired), Maharashtra State.

https://www.theperfectvoice.in/post/a-wake-up-call-for-security-in-our-public-institution

Vulnerability of School – going kids

Praveen Dixit

DGP (Retired) Maharashtra State

Recent incidents of sexual assault at a school on young school going kids of 3-4 years in Badlapur near Mumbai and rape and murder of resident   doctor at R.G.Kar public hospital at Kolkata shocked the public conscience through out the country. In both the incidents, the culprits had free access to isolated places within the public institutes and were successful in executing their obnoxious activities without being noticed. At the school in Badlapur, the kids of 3-4 years could not even understand what atrocity was being committed on them for a prolonged period of fifteen days. In R.G. Kar hospital, the culprit murdered the victim after rape and thus the victim would never be able to inform about the sad happenings. While the investigation in Badlapur incident is being conducted by Special Investigation Team (SIT) appointed by Maharashtra government, the R.G.Kar incident is investigated by CBI . At both incidents, the culprits had selected places where there was no arrangement for CCTV footage which would have helped in getting detected. Both places were completely isolated even though in public institutes and thus there are no witnesses. In the incident at Badlapur school, when the young kid complained about her pain in private parts, the parents didn’t refer her to private doctors for examination, even though that would have revealed the damage helping for further legal action. When the matter was brought to the notice of head mistress, she didn’t reveal it to school authorities for three- four days.  Authorities also failed in informing the matter to police immediately as required under POCSO Act. When the matter was referred to police, they sent the kids to public hospital for examination, recorded the statements of parents and registered the offence after twelve hours. Investigation revealed, the suspect was employed as casual contract sweeper two weeks ago and was moving freely even in ladies’ toilets without any identity card. The contractor didn’t verify his antecedents before using him as contractual labour.

The Bombay High Court directed the police to register an offence against the school authorities for their failure to inform about the incident immediately. The Court also underlined the need to sensitise the police about offences against children. In offences against women and children, police may be first respondents, investigators or officers to register F.I.R. It is primary duty of the police to create awareness of the legal rights   among the victims, play active role in preventing these crimes and detect and investigate these crimes. Many women are unaware of the system to redress these grievances and are reluctant to register a complaint due to shame and ignominy associated with these crimes. While knowledge and skills to investigate are imparted during training, it is imperative that the focus of training should be broadened from ‘knowledge and skills ‘to include attitudinal transformation as an important component. When the complainant approaches the police, police behaviour would determine how the complainant would react and cooperates with them. Attitude reflects in behaviour and it can be changed by training.

To ensure fairness, police need to take following precautions: who receives the complainant first in the police station? How much time is taken to write down the complaint, whether the complaint is recorded as mentioned by her or reduced in gravity, whether the complaint is recorded in the words and language as mentioned, whether audio-visual recording is done of the complainant, whether there was any demand of illegal gratification. In each complaint by a woman or about a child -girl, the DCP should contact the complainant subsequently and verify above details and keep a record of the same. Awareness also needs to be created about the facility of e-FIR under the recently implemented Bharatiya Nyaya Sanhita (BNS)2023. This facilitates lodging the complaint without visiting to police station.

Educational authorities also need to pay attention to requirements of security during their visits to schools. They need to emphasise on immediate reporting of every incident against the child to police even though it may appear to be embarrassing them. Similarly, it is necessary to review the policy of using contractual labour for house-keeping. Though it may save the institute from paying retirement benefits to the employee, but the cost of such contractual workers’ behaviour is more damaging to the institute.  

As far as assaults against health workers in public hospitals are concerned, I was given the task to review the security requirements of medical colleges and hospitals in Maharashtra. Accordingly, trained personnel from Maharashtra Security Force (MSF) were deployed for surveillance, monitoring as well as quick response. They were also equipped with necessary equipment, CCTV facilities and weapons to prevent any unfortunate incidents. This arrangement is working effectively for last seven years. This system in force in Maharashtra needs to be emulated in other states in India as well.

**************   *************   *************

बदलापूरची घटना

प्रवीण दीक्षित.

(निवृत्त पोलीस महासंचालक)

बदलापूर येथील शाळेतील तीन-चार वर्षाच्या दोन छोट्या मुलींवर शाळेने पंधरा दिवसापूर्वीच कंत्राटाने नेमलेल्या कर्मचार्‍याने दुष्कृत्य केल्याच्या दुर्दैवी घटनेने संपूर्ण महाराष्ट्र सुन्न झाला. मुलींच्या पालकांनी ही माहिती शाळेच्या मुख्याध्यापिकांना दिल्यानंतरही चार दिवस त्यांनी त्याबद्दल पोलीस ठाण्यामधे तक्रार दिली नाही. त्यानंतर पोलीस ठाण्यात कळवल्यानंतर एक दिवसानी पोलीसांनी प्रथम खबरी अहवालाची नोंद केली. ह्या घटनेची शासनाने गंभीर दखल घेऊन कंत्राटदारास चौकशी न करता कर्मचार्‍यास नेमल्याबद्दल काळ्या यादीत टाकले. मुख्याध्यापिकांना निलंबित करण्यात आले. शाळेवर प्रशासकाची नेमणूक करण्यात आली व तीन पोलीस अधिकार्‍यांना कामातील हलगर्जीपणासाठी निलंबित करण्यात आले.

ह्या घटनेने महिला व लहान मुली ह्यांच्याविरुद्ध होणार्‍या तक्रारी/गुन्हे ह्यांच्याबाबत पोलीस तक्रारदारांशी वागताना सौजन्य आणि संवेदनशीलता दाखवतात का? हा महत्त्वाचा प्रश्न पुन्हा एकदा ऐरणीवर आला आहे. महिलांबाबतच्या तक्रारींमधे, आपण अत्याचाराचे बळी आहोत हे सांगताना वाटणार्‍या अपराधीपणाने, लोकलज्जेस्तव महिला तसेच लहान मुलींचे पालक त्याविरुद्ध तक्रार करायला धजावत नाहीत. बर्‍याचवेळा आपल्याला न्याय कसा मिळवता येईल ह्याबाबतही अनभिज्ञता असते. त्यामुळे पोलीसांचे कर्तव्य आहे की, समाजात स्त्रिया / बालिकांविरुद्ध गुन्हयांबाबत जागरुकता निर्माण करणे, हे गु्न्हे होणार नाहीत ह्यासाठी सक्रीय प्रयत्न करणे व अशा गुन्ह्यातील आरोपी शोधून सदर घटनेचा तपास करून न्यायालयात सादर करणे. अशा घटनांमधे सर्व प्रथम कारवाई करणारे, तपास करणारे वा ठाणे अम्मलदार म्हणून प्रथम खबरीची नोंद घेणारे म्हणून पोलीस ओळखले जातात.

ज्या वेळेस आपण पोलीसांची वागणूक योग्य असावी असे म्हणतो त्यावेळेस पोलीसांना तपास करण्याची उत्तम माहिती, व्यवसाय कौशल्य व योग्य वागणूक व दृष्टिकोन अपेक्षित आहे. पोलीसांना पीडितेबद्दल संवेदनशीलता, विशिष्ट गुन्ह्यात तपास करायची पद्धत, पीडित व साक्षीदारांना संरक्षण आणि गुन्ह्यांचे न्यायालयासमोर योग्य सादरी करण करणे ह्याचे ज्ञान असावे असे अपेक्षित आहे. पोलीसांना कौशल्यामधे भरभक्कम पुरावा गोळा करणे, गुन्ह्याचा तपास करणे, पीडितेला वेळेवर व उचित नुकसानभरपाई मिळवून देणे व पीडितेचे पुनर्वसन करणे अपेक्षित आहे. पोलीस तक्रारदारांना कसे वागवतात ह्या त्यांच्या वागणुकीतून त्यांचा दृष्टिकोन स्पष्ट होतो. दृष्टिकोन बदलण्यासाठी त्यांना परिणामकारक सल्ला देणे, कामात मार्गदर्शन करणे, प्रशिक्षण व दृष्टिकोन बदल करण्याच्या उपाययोजना अपेक्षित आहेत. दृष्टिकोन म्हणजेः जाणीवपूर्वक, घडणार्‍या गोष्टी, माणसे, वस्तू, घटना ह्यांच्या बाबत सकारात्मकतेने किंवा नकारात्मकतेने विचार करणे.

पोलीस प्रशिक्षणात ज्ञान व कौशल्ये शिकविण्यावर भर दिला जातो. मुंबई उच्च न्यायालयाने अधोरेखित केल्याप्रमाणे गरज आहे ती पोलीस प्रशिक्षणात आमूलाग्र बदल करून वागणूक व दृष्टिकोन बदलण्यावर भर देण्याची व ते सकारात्मक करण्याची. महिला किंवा बालिकेचे पालक तक्रार करण्यासाठी पोलीस ठाण्यात येतात तेव्हा पोलीस त्यांच्याशी कसे वागतात त्याप्रमाणे तक्रारदार किती सहकार्य करणार किंवा काय प्रतिक्रिया देणार ते ठरत असते. हे करत असताना पोलीसांनी खबरदारी घेणे गरजेचे आहे की, महिला/पालक तक्रार करायला येतात तेव्हा सर्वप्रथम कोण भेटते, तक्रार लिहून घेण्यास किती वेळ लागतो, तक्रार सांगितल्याप्रमाणे लिहीली जाते का, तक्रारीचे गांभीर्य कमी करून लिहीली जाते का, त्याचप्रमाणे तक्रार जशी सांगितली जाते त्या भाषेत व त्या शब्दात लिहीली जाते का, तक्रार लिहून घेताना दृक-श्राव्य माध्यमाचा उपयोग केला जातो का, तक्रार घेताना लाच मागितली गेली होती का? पोलीस उपायुक्त दर्जाच्या अधिकार्‍याने हया गोष्टी स्वतंत्रपणे तक्रारदाराशी संपर्क करून तपासून पाहिल्या का? व तशी नोंद ठेवली का? हे अत्यंत महत्त्वाचे आहे.

बदलापूरसारखी घटना पुन्हा होऊ नये ह्यासाठी सर्व पोलीस अधिकार्‍यांना वरील गोष्टी वारंवार सांगणे गरजेचे आहे. असेच प्रशिक्षण शाळांचे मुख्याध्यापक, महिलांच्या निवासस्थानांचे संचालक ह्यांनाही देणे गरजेचे आहे. भारत सरकार व महाराष्ट्र शासन ह्यांनी विविध स्तरांवर अपेक्षित कारवाईबद्दल सविस्तर शासन निर्णय नुकतेच पुन्हा प्रसृत केले आहेत. त्यांची काटेकोरपणे अम्मलबजावणी अपेक्षित आहे. त्याचबरोबर लहान बालिकांबद्दलची संवेदनशीलता लक्षात घेऊन कंत्राटी कामगार नेण्याची पद्धत रद्द करून त्याठिकाणी प्रशिक्षित व विश्वासू कर्मचारी नेमण्याचा सुद्धा पुनर्विचार करण्याची गरज आहे.

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दखल शस्त्रे नेमकी कशासाठी?

                   – प्रवीण दीक्षित,

 निवृत्त पोलिस महासंचालक

              अलिकडे महाराष्ट्र गंभीर घटनांनी हादरुन गेला. शस्त्रांचा वापर करत केलेले जीवघेणे हल्ले हे काहींना संपवून तर काहींना जखमी करुन गेले. मात्र मुंबई, ठाणे, पुणे, उल्हासनगर आदी ठिकाणच्या घटना पाहता त्यामागे वैयक्तिक कारणे आणि वैमनस्य दिसून येते. त्यामुळे त्याला टोळीयुद्ध म्हणण्याचे वा समजण्याचे कारण नाही. अर्थात या निमित्ताने शस्त्र परवाना धोरण वा शस्त्रांची हाताळणी या विषयावर मात्र पुन्हा विचार करावा लागेल.

                मुंबई, ठाणे, पुणे,नागपूर आदी महानगरांमध्ये तसेच इतरत्रही परवानाधारक शस्त्रातून गोळीबाराच्या घटना घडत असून, ती चिंतेची बाब आहे. यातून कुठे मृत्यू तर कोणी जखमी होण्याच्या बातम्या वारंवार कानावर पडत आहेत. यास कुठलेही शहर अपवाद नाही. त्यामुळेच हल्लेखोरांकडे इतयया सोयिस्कर पद्धतीने शस्त्रे येतात कशी हा विचार मनात येतो. आपल्याकडे शस्त्र कायद्यानुसार जिल्ह्यामध्ये जिल्हाधिकारी तसेच पोलिस आयुक्तालय असेल तिथे पोलिस आयुक्त यांना शस्त्र परवानगी देण्याचे अधिकार आहेत. यामध्येही जिल्हाअंतर्गत व जिल्ह्याबाहेर असे दोन प्रकार आहेत. आधी शस्त्रे बाळगण्यासाठी संबंधित अर्जदाराने दिलेले कारण तसेच त्याच्या जीवाला असणारी भीती याबाबत पडताळणी केली जाते. चौकशीअंती ठरावीक काळासाठी परवाना मिळतो.  वेळोवेळी त्याचे नूतनीकरण करावे लागते. परवानाधारक व्यक्तीचा मृत्यू झाल्यास त्यांच्या वारसदारांनाही परवाना सहज मिळू शकत नाही. त्यांनाही सर्व प्रक्रिया पार करूनच परवाना दिला जातो. ही झाली शस्त्रे बाळगण्याची कायदेशीर पद्धत.

 मात्र, माफियांना गावठी, विदेशी पिस्तूल बेकायदेशीर मार्गाने सहज उपलब्ध होताना दिसत आहेत.  बंदुकीच्या धाकाने उद्योजक, व्यावसायिकांसह विविध क्षेत्रातील मंडळींना खंडणीसाठी धमकावले जाते. याच भीतीतून स्वसंरक्षणासाठी ही मंडळी शस्त्र परवान्याची मागणी करतात. दुसरीकडे माफिया, खंडणी मागणारे, दहशतवादी, माओवादी यांना बहुतांश शस्त्र चीन आणि पाकिस्तान सीमेपलीकडून मिळताना दिसतात. पाकिस्तानने तर उघड उघड ड्रोनच्या मदतीने देशविघातक शक्तीपर्यंत शस्त्र पुरवल्याचेही समोर आले आहे. 

                  हे लक्षात घेता अशा घटनांना आळा घालायचा तर बेकायदा येणारी शस्त्रे, त्यांचे माध्यम, ठिकाणे शोधून कठोर कारवाई करायला हवी. शस्त्र देणार्‍या अधिकार्‍यांनी गैरप्रकार केल्याचे आढळताच संबंधित जिल्हाधिकारी किंवा पोलिस आयुक्तांवर तातडीने कारवाई करायला हवी. जेणेकरून इतरांना यातून धडा मिळेल. सगळ्या गोष्टींचा विचार करून शासनाने शस्त्र परवाना धोरणात, काळाप्रमाणे योग्य ते बदल करण्याची वेळ आता आली आहे, हेच अशा घटनांच्या पार्श्‍वभूमीवर सांगता येईल.
अर्थात एका जिल्ह्यामध्ये किंवा शहरामध्ये कडक धोरण राबवत शस्त्र परवाना न देण्याचे ठरवले तरी, नागरिक दुसर्‍या मार्गाने भ्रष्टाचार करून तसेच त्यांना राजकीय दृष्टीने अनुकूल भागातून संपूर्ण देशामध्ये वापरता येईल असा शस्त्र परवाना मिळवतात. उत्तर प्रदेश, बिहारसारख्या राज्यांमधून गुन्हेगारी प्रवृत्तीच्या लोकांनी बरीचशी शस्त्रे मिळवली आहेत.काही वर्षांपूर्वी  काश्मीरमधून मोठ्या प्रमाणात भ्रष्टाचार करून शस्त्र परववाने देण्यात आले होते राजकीय दबावाने अथवा भ्रष्टाचाराने ती मिळवली आहेत. ती देशभर कुठेही वापरण्याच्या परवान्याची असतात. आज हेच लोक ती घेऊन मुंबई सारख्या मोठमोठ्या शहरात वावरतात. म्हणूनच महाराष्ट्राबाहेरचे शस्त्रपरवाने काळजीपूर्वक तपासणे गरजेचे आहे. खेरीज कोणत्या जिल्हाधिकार्‍याने शस्त्र दिले हे जाणून घेऊन त्यांच्याकडेही चौकशी होणे गरजेचे आहे. कारण एखादी नोकरी मिळवण्यासाठी वा अन्य लाभ घेण्यासाठीही लोक शस्त्रपरवान्याची विनंती करतात. त्यामुळेच परवाने धारक व्यक्तीला खरोखरच स्वसंरक्षणार्थ शस्त्र बाळगणे आवश्यकत आहे का? याची पुन्हा एकदा तपासणी व्हायला हवी. पूर्वी अशी तपासणी अवघड होती. मात्र आता तंत्रज्ञान बरेच पुढे गेले आहे. त्यामुळे महाराष्ट्रातील कोणत्याही आयुक्ताला दुसर्‍या राज्यातील आयुक्ताशी संपर्क करुन यासंबंधी माहिती घ्यावीशी वाटली तर फारसे अवघड नाही.
शस्त्रपरवान्याविषयीची माहिती आयुक्त वा जिल्हाधिकार्‍यांलाच ठाऊक असते. पण आता यात महत्त्वपूर्ण बदल घडणे गरजेचे आहे. तुम्ही शस्त्रपरवाना दिला तर तो स्थानिक पातळीवर आहे की संपूर्ण देशपातळीवरील आहे, यासंबंधीचा खुलासा तातडीने गृहमंत्रालय आणि सर्व जिल्हांच्या अधिकार्‍यांना कळवायला हवा. त्यासाठी भारत सरकारने एक पोर्टल तयार करणे गरजेचे आहे. ज्यावर सर्व शस्त्रधारकांची माहिती, त्यांचा आधार क्रमांक ही माहिती सहज मिळेल.  यामुळे कोणाकडे परवानाधारक शस्त्रे आहेत ही माहिती पारदर्शक पद्धतीने सर्वांना उपलब्ध होईल. राज्यवार, जिल्हावार अशी माहिती असेल तर अनेक गोष्टींची स्पष्टता होऊ शकेल. उदाहरणार्थ, एखाद्याकडे परवाना असणारे शस्त्र असेल आणि त्याने ते कोणा दुसर्‍याला दिले तर लगेचच तपासता येईल. सध्या अशी पडताळणी करणे वेळखाऊ आहे.  एखादे शस्त्र त्या धारकाचे आहे की नाही आणि ते परवाना असणारे आहे की नाही यासंबंधी कळणे सध्या अवघड आहे. मात्र माहितीमध्ये पारदर्शकता आवश्यक आहे. 

                 यासंदर्भातील आणखी एक बाब म्हणजे काही जमातींचा पारंपरिक व्यवसायच शस्त्र बनविण्याचा आहे. ते कुठलेही शस्त्र हुबेहूब बनवतात आणि सर्रास त्यांची विक्री करताना दिसतात. पाकिस्तानसारख्या काही देशांमध्ये शस्त्रांचा बाजार भरतो. तिथे एके 47 पासून सर्व प्रकारची शस्त्रे मिळतात. भारतातही अनेक ठिकाणी अशीच शस्त्रे मिळताना दिसतात. त्याठिकाणी कठोर कारवाई करत शस्त्र तयार करणार्‍या लोकांचे पुनर्वसन करणे गरजेचे आहे. त्यामुळेही अयोग्य व्यक्तींच्या हाती शस्त्रे येण्यास पायबंद घालता येईल. सार्वजनिक शांतता, उत्कृष्ट सुरक्षितता ठेवण्यासाठी पोलिसांनी आणि न्यायालयाने कठोर भूमिका घेत कारवाई करायला हवी.
ड्युटीवर असताना पोलीस अधिकार्‍यांकडे शासकीय सर्व्हिस रिव्हॉलवर उपलब्ध असते परंतू ती व्यक्ती पोलीस अधिकारी असल्याचे गुन्हेगार जाणून असतात. त्यामुळेच त्या अधिकार्‍यांवर लक्ष ठेवून गुन्हेगार पोलिसांचा जीव घेण्यासही मागे–पुढे पाहात नाहीत. दुसरीकडे सतत गुन्हेगारी कृत्यांसंदर्भात काम करणार्‍या पोलीस अधिकार्‍यांना सुलभ पद्धतीने शस्त्रपरवाना मिळत नाही. ते मिळवण्यासाठी त्यांना अनेक अडचणींचा सामना करावा लागतो. हे लक्षात घेता अशा अधिकार्‍यांना स्वत:चे संरक्षण करण्यासाठी शस्त्रपरवाना देणे आवश्यक आहे, ज्या ठिकाणी पोलिस ठाण्यावर हल्ला करून शस्त्रे पळवली असतील, ते प्रत्येक शस्त्र परत मिळवणे गरजेचे आहे. 

              शस्त्रांचा वापर करुन जीवे मारण्याच्या ताज्या घटनांद्वारे वाढत्या गुन्हेगारीची बाब पुन्हा एकदा चर्चेत आली आहे. पण इथे लक्षात घ्यायला हवे की मुंबई, उल्हासनगर, ठाणे वा पुणे येथे घडलेले गुन्हे वैयक्तिक वैमनस्यातून झाले आहेत. याला कोणत्याही प्रकारे टोळीयुद्ध म्हणणे वा तसे स्वरुप देणे योग्य नाही. पैशाचे व्यवहार, वैयक्तिक आरोप, वैमनस्य आदी कारणांमधून हे गुन्हे घडल्याचे समजून येते. त्यामुळेच अलिकडे घडलेले हे गुन्हे म्हणजे टोळीयुद्धाची सुरूवात आहे, असे म्हणता येणार नाही. अगदी घोसाळकर हल्ला प्रकरणातही कोणी नगरसेवक व्हायचे, कोणी राजकीय पुढारीपण मिरवायचे या स्वरुपातील वैयक्तिक कारणांमुळे असलेले वैमनस्य समोर येते. या लोकांकडून छोटे–मोठे गुन्हे घडत असतात तेव्हा तपास करताना त्यांच्या रेकॉर्डमध्ये गुन्हेगारी पार्श्‍वभूमी समजते. अशा तुरुंगात असणार्‍या वा तुरुंगातून बाहेर असणार्‍या गुन्हेगारांवर पोलिसांनी लक्ष ठेवणे अत्यंत गरजेचे आहे. कारण या लोकांनी अनेक शत्रू निर्माण केलेले असतात. त्यामुळेच हा गुन्हेगार तुरुंगातून कधी बाहेर येतो आणि कधी आपण याला संपवतो याची त्यांचे शत्रू वाटच बघत असतात. त्यामुळेच अगदी पॅरोलवर बाहेर असले वा शिक्षा संपवून बाहेर आले असले तरी पोलिसांनी त्यांच्यावर सतत नजर ठेवणे आवश्यक आहे. इतकेच नव्हे तर पोलिसांनी या लोकांनाही तुझ्या जीवाला धोका असल्याची समज देणे गरजेचे आहे. 

              शस्त्रे आणि अमली पदार्थांचे व्यवहार यांचा निकटचा संबंध आहे. यातून शस्त्रांचे मोठमोठे व्यापार होतात. आत्तापर्यंत झालेल्या तपासातून वारंवार ही बाब स्पष्ट आहे. त्यामुळेच या बाबीला आळा घालण्यासाठी अमली पदार्थांच्या तस्करीवर, विक्रीवरही मोठ्या प्रमाणात नियंत्रण आणणे गरजेचे आहे. तरच अशा घटना कमी होणे शयय होईल. दुसरे म्हणजे गावठी कट्टे बनवणार्‍या शिकलगार समाजासारख्या लोकांचे पुनर्वसन करणेही गरजेचे आहे. आजही हे लोक आपापल्या वस्तीमध्ये शस्त्रे बनवून विकत असतात. त्यामुळेच त्यांची ओळख पटवून, त्यांना योग्य ती मदत देऊ करत पुनर्वसन घडवून आणले तर हे लोक शस्त्रे बनवणार नाहीत. बरेचदा शस्त्रे, दारुगोळा निर्माण करणार्‍या कारखान्यातूनही शस्त्रास्त्रांची चोरी होते. हेदेखील तातडीने बंद व्हायला हवे कारण पुढे हीच चोरीची शस्त्रे गुन्ह्यांसाठी वापरली जातात. अशा विविध पातळ्यांवरुन प्रयत्न केले तरच गुन्ह्यांमध्ये शस्त्रांचा वापर कमी होणे शयय होईल.

  (शब्दांकन– स्वाती पेशवे) (अद्वैत फीचर्स)